Mind Over Madness : Haunting things that insinuate themselves into real lives : THE ZOO WHERE YOU’RE FED TO GOD, <i> By Michael Ventura (Simon & Schuster: $21; 255 pp.)</i>

Nervous breakdown is a term famous and useful for its imprecision; it encompasses a multitude of maladies, some slight, some grim. It can be a weekly problem brought on by the laundry or an extended season of mental anguish brought on by forces never fully understood. In Michael Ventura’s engaging new novel “The Zoo Where You’re Fed to God,” he explores something closer to the latter, but with idiosyncratic permutations that make it at times feel like a clinical ailment that might have a five-syllable name and at times like an intense visionary madness.

At the heart of the book is James Abbey, a 50-year-old surgeon, who has come into a dark time in his life. Ventura’s choice here, of a doctor incapable of healing himself, a stoic pragmatist, who begins confronting impractical vexations, is a significant part of the novel’s depth. As the good doctor moves through the many passages of his dread, he understands fully the physiological responses in his every activity, but not what is really happening. Seasoned by his medical work “one big mangled body,” which he must operate on endlessly, he’s begun to see all of life “through the knife.”

As the novel opens he’s living alone in the Echo Park section of Los Angeles, separated from his wife, Elizabeth, and Eddie, his 11-year-old son. His divorce is explained as having resulted from the doctor’s “sensitivities”--another euphemism for his “condition”--and the first thrilling paragraph sets out his paradox:

“He became a surgeon because he was afraid of knives. He got married because he was afraid of women. He had a child because he was afraid of responsibility. Now, his marriage over and his child no longer speaking to him, he turned off the lights in the house because he was afraid of the dark.”

The book locks on and sustains an intense interior tone almost all of it from inside the doctor’s mind. He dwells on things, words, rotating them slowly like objects removed during surgery, scrutinizing, wondering, evaluating. It is a highly effective point of view because Ventura stays uncannily close. It gains credibility simply because the doctor sounds not like a character in a book but like a free agent trying to think his way to a foothold. Even when Dr. Abbey goes to the zoo and begins hearing voices, instructions from his dear tigers, the kind of beat that has unmoored other narratives, we stay in, because the thinking is neither grand nor deft, but true and painful.

The plot that is the skeleton of linked events in this cerebral book involves the doctor’s estrangement from his son, Eddie, a child who is written with a delicacy and accuracy that makes him matter. At 11 he knows everything and nothing by turns, but he is aware of his emotional life and his place between these two confused adults. A standout player in this drama is the therapist, Dr. Benjamin, who breaks the stereotype with more panache and verve than we’ve seen for a while; he takes over his sections of the book and even his last phone message is a treasure. What a pleasure to encounter a secondary player in a novel who has enough heat to create a place and amplify everyone else.

At the zoo, in the midst of his descent, as confused and consumed as he’s been, the doctor meets--and this may be the right term here--a kindred spirit, the equally intense Lee, a woman about 22 or 23, who has some troubles of her own. She kind of knows what’s going on with him, she loves things deeply too, and they form, no surprise, a stunning kinship that becomes--in a surprising way--key to the novel. Their dialogue about what’s going on and what’s OK is the deep center of this book; they meet on a wavelength that feels dangerous and fragile and what they make of it and take from it opens the ending of this story.

A novel like this can be frustrating as it ventures onto the thin ice of the abstract ways the mind works. Are the doctor’s troubles the result of his religious mother? Are his new revelations the result of the old? Is he just another modern man who has seen--through his knife--into the abyss? In the end here, its ambiguities don’t harm the book. At one point Lee tells the doctor, whom she calls “Doc”: “There aren’t any bad guys here, that’s the trouble. That’s why our stories aren’t in the movies.” And he responds, “As many bad guys as there are in the world, there still aren’t enough to make life as simple as we want it to be.” This novel’s greatest strength, in fact results from Ventura’s not being afraid of things without easy names, haunting things that insinuate themselves into real lives, complicated things.

The nervous doctor in this powerful book faces dread by connecting with the animal world and he begins to break down the membrane between terror and paradise.

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